ACW Partner Invitation Letter

To join the over 400 organisation strong ACW campaign, please go to www.aidscarewatch.org

Dear Friends,

More than three million people lost their lives to AIDS during the course of 2006.

Many of you are fully aware of this grim fact and are working hard to bring about change and save lives by advocating for essential, life-saving medicines to extend the lives of people living with HIV.

As with any advocacy work, new challenges constantly present themselves. Many treatment access efforts are happening in isolation, not least because priorities differ from one region to another and between specific country and community contexts.

As a global community, we also dedicate a great deal of our energies reacting to new circumstances, bad decisions and broken promises – this leaves little in reserve for proactive and coordinated AIDS care advocacy agendas. The lack of an overarching and proactive advocacy agenda, focusing on comprehensive care and treatment needs, is arguably one of the costs this fragmentation has created.

While we all agree that universal access to antiretroviral drugs is a vital priority, we are nevertheless seeing our friends, family and colleagues die because ARVs, and other affordable, effective care and treatment options, are often not available when they are needed. That is not going to change tomorrow, next month, or in the foreseeable future.

In response to this reality, an unprecedented global civil society campaign - AIDS-Care-Watch (ACW) - has been conceived to provide an avenue for treatment activists and advocates worldwide to come together to soundly advocate for a comprehensive care package for people living with HIV/AIDS.

Comprehensive care for people living with HIV/AIDS is clearly not a new idea. But a unified, popular and vocal advocacy campaign to promote it is. Each of us living with and/or working on HIV/AIDS recognize that a full range of care and treatment elements is required to improve and extend our lives. Access to treatment/prevention for tuberculosis and other opportunistic infections, voluntary counseling and testing, assured food security, home and community based care, among others, are all part of the essential AIDS care package.

AIDS-Care-Watch advocates for a comprehensive package of HIV/AIDS care and treatment services under one standard. By keeping the advocacy agenda of AIDS-Care-Watch broad, it is proving relevant to most communities and appeals to activists, advocates, AIDS service organizations and people with HIV globally. This is crucial to generating a single collective voice to impact decisions related to care and treatment at all levels.

AIDS-Care-Watch does not intend to become ‘another’ in the list of advocacy initiatives. Nor does it set out to undermine or compete with the advocacy work already happening in this area, rather to help bring them together and to build further.

To achieve this, it simply aims to unify some of our disconnected efforts and priorities in relation to care and treatment advocacy. In this way, ACW helps us all to more clearly articulate to national governments, international agencies, funders and others what the overall care and treatment needs of people living with HIV/AIDS are, and to provide advocates around the world an initial road map for doing so with a clear message.

To find out more about AIDS-Care-Watch Campaign, including how to join over 400 global partners that have already taken their place in the campaign, there are three immediate steps you can take:

Find out more about AIDS-Care-Watch at http://www.aidscarewatch.org/

Join the campaign! Sign up as a campaign partner at thttp://www.aidscarewatch.org/cms/partners_form.asp

Email the Campaign Coordinator at tina@aidscarewatch.org with questions or comments.

***ACW can easily provide you with a formal ‘partner invitation’ letter should your organisation need it for a formal process required prior to officially signing onto a global campaign. Contact Tina at tina@aidscarewatch.org to request such a letter.

We greatly look forward to hearing from you and, hopefully working with you to meet our collective goal of reducing the number of preventable AIDS related deaths in 2007.

Best wishes,

Tina Noga Bjerno
AIDS Care Watch Campaign Coordinator
Chiang Mai, Thailand
~~~~~~~~

tina@aidscarewatch.org
www.aidscarewatch.org

Campaign highlights essential treatment and care options for HIV/AIDS

Chiang Mai Mail Newspaper
April 2005

“In the first three months of 2005 alone, more people have already died from AIDS-related conditions than the total number taking antiretroviral drugs throughout the world. This grim milestone is a stark reminder that as we grapple with the scale-up of global ARV access, we have to keep people with HIV alive in all possible ways,” said Abby Erikson, AIDS Care Watch campaign coordinator.

The monthly NGO forum held in Chiang Mai, Thailand was just one of several events taking place globally to launch the new AIDS Care Watch (ACW) campaign. The forum brought together people living with HIV/AIDS (PWHA), NGO workers and other interested members of the community to discuss the themes of the campaign: Listening to voices that matter, staying alive with HIV.

Introducing the speakers, forum moderator, Ajaarn Laurie Maund, of the Sangha Metta Project emphasized the vital importance of the campaign. He stressed that there are many ways to keep people living with HIV alive.

Abby Erikson opened the forum by showing a series of images representing ‘voices that matter’. The images were of activists, care workers and people living with HIV/AIDS from all over the world. “These people are fighting for the rights of those living with and affected by HIV. They are people who are inciting hope and working hard in their communities to keep people with HIV/AIDS alive and healthy, and often in situations where access to antiretroviral drugs is unavailable or under-available,” said Ms. Erikson.

“This is what the campaign is about. It is about listening to civil society and people living with HIV/AIDS. It is about us sitting in this room, coming together to let others know what care and treatment we need in our communities.”

Forum moderator, Ajaarn Laurie Maund, of the Sangha Metta Project

Ms Erikson explained that the idea for the campaign emerged during the last International AIDS Conference held in Bangkok in July 2004, where it became clear that the large-scale AIDS treatment initiatives (such as the World Health Organization’s ‘3 by 5’ initiative and the US’s emergency plan for AIDS relief) will not meet their AIDS treatment goals as soon as expected or needed.

The ACW campaign aims to highlight all HIV/AIDS care and treatment options available to people living with HIV. For the millions of people living with HIV who are not able to afford or access ARV treatment in the next few years, there are many ways that their lives can be extended.”

The forum in Chiang Mai focused on three of most pressing care and treatment issues for people living with HIV in Thailand: prevention and treatment of TB; tackling HIV related stigma; and pharmacotherapy for recovering drug users, the speakers that followed illustrated some of the ways in which people can be kept alive with HIV.

Representing the Office of Disease Prevention and Control, Sumalee Amarinsangpen spoke about the importance of providing prevention and treatment of tuberculosis to those living with HIV/AIDS. Northern Thailand has a particularly high rate of TB infection and a high level of TB/HIV co-infection. Sumalee emphasized the role that TB treatment plays in extending the lives of people living with HIV/AIDS. “It is vital that we develop integrated care for HIV and TB,” she said.

Addressing the devastating impact that stigma has on people living with HIV/AIDS, Bounnieum Vongjaikham, vice president of the Thai Upper North Network of people living with HIV/AIDS said, “How can PWHA maintain a good standard of life when society looks on them as germs?” Bounnieum spoke of the high level of ignorance and misconception that still exists in Thailand, partly because of early government campaigns that wrongly purported that ‘AIDS = death’. The stigmatization of people living with HIV/AIDS discourages many from disclosing their condition and seeking help, and restricts access to vital services and information. “Many people with AIDS die of opportunistic infections that are treatable and preventable,” he said.

Pharmacotherapy also plays a vital role in rehabilitating injecting drug users (IDUs) and can be an important way of maintaining the health of PWHA drug users. This was the issue raised by Montira Mayta of the Faa Mai Drug Dependency Treatment Centre. Montira explained how methadone maintenance treatment (MMT) worked and how much success they had had in working with IDUs. Some of the highest rates of HIV infection are to be found among injecting drug users but, Montira stressed, “MMT can help to significantly extend the lives of PWHAs. They no longer need to go back to heroine and no longer share needles, thus avoiding new infections that are detrimental to their health”.

Finally, Mae Chee Wirawan, a nun working with the Clear Sky Project addressed the participants. She talked of the importance of acknowledging our physical suffering and of finding ways to heal our mental pain. Recognizing the harmful effect of stigma, she advised, “No one can hurt us if our heart and mind are strong – this is what the Buddha teaches us.”

In the remaining time for participants to raise issues from the floor ‘stigma’ dominated as an impediment to healthy living for PWHAs. One of the participants called for “moral support for people with HIV to continue their lives”, and added, “Restoration of human dignity among PWHAs is essential.”

Bringing the forum to a close Ajaarn Laurie left us with this thought, “There are many people affected for every one infected. Helping someone with HIV to stay alive is helping families to stay alive.”


(April 2005)

ACW Statement 5: The AIDS-Care-Watch Campaign

The goal of the AIDS-Care-Watch Campaign is to reduce the number of preventable HIV/AIDS-related deaths each year. The Campaign uses a backbone of country-based reporting, documentation and analysis to:

Compile and validate qualitative evidence on the availability and quality of care services available to PWHAs.

Raise awareness about the importance of all AIDS care options to keep people living with HIV while ARV expansion programmes deliver on their promise.

Highlight instances and examples where comprehensive care is provided for people living with HIV, particularly those at a local level.

Recognise the remarkable achievements of front-line health and social workers.
Identify critical opportunities and needs for health systems improvements.

Hold relevant institutions and organisations accountable against their explicit commitments on provision of HIV/AIDS care.

ACW Statement 4: Why now? Why 2005?

2005 is a particularly significant year and a potential ‘tipping point’ in relation to HIV/AIDS care.

First and foremost, a further 3 million people will die as a result of largely preventable and treatable AIDS-related conditions.

2005 is also the mid-point benchmark for a significant prior commitment by the international community in relation to AIDS care. Four years ago, and under the heading of ‘Global Crisis – Global Action’, the United Nations (UN) General Assembly held an unprecedented special session on HIV/AIDS – the first time the assembly had ever addressed a specific health issue. The resulting Declaration of Commitment on HIV/AIDS, signed by all Member States of the UN, made explicit pledges to “..make significant progress in implementing comprehensive [HIV/AIDS] care strategies” by 2005.

In 2005 the WHO ‘3 by 5’ initiative also reaches its own benchmark and it will be vital to know whether it has succeeded in ensuring access to ARVs for 3 million people in the developing world.

With the Millennium Campaign gaining momentum, 2005 will likely also be an important turning point in relation to the Millennium Development Goals. During the historic gathering of Heads of State in September 2000, our leaders identified health issues as the top-most priority for the new millennium, with concrete targets to be achieved by 2015.

Each of theses declarations and commitments include explicit statements by all governments of what they can and should be held accountable for when it comes to HIV/AIDS-related care.

ACW Statement 3: An achievable future

Reaching for the ultimate goal of universal access to ARV drugs is clearly vital – but as we strive for that goal we must protect people’s right to health and keep them alive in all possible ways.

Three of the possible ways people living with HIV can be helped to survive the long wait for ARVs are:

Ensuring widespread access to comprehensive care and treatment approaches: to help people discover their HIV status, delay progression to AIDS and to prevent and treat HIV-associated conditions;

Improving health literacy among people living with HIV: particularly in relation to ‘early’ HIV-associated conditions, their prevention, management and drug treatment;

Identifying and minimising the factors that accelerate the development of AIDS-related conditions.

Employers, academic institutions, civil society groups, PWHA networks, health workers, media representatives, government bodies, advocacy groups, pharmaceutical companies and faith-based organisations should be giving more urgent attention to these relatively simple approaches to keeping people with HIV alive. Many of them are already readily available, affordable and effective.

They include:

Voluntary counselling and testing for HIV as the entry point for access to all health care services and self management

Prevention and treatment of tuberculosis (TB) in people living with HIV
Drugs to treat/prevent other opportunistic infections (e.g., cotrimoxazole, fluconazole etc)

Home- and community-based care approaches

Tackling HIV-related stigma, especially in health care settings, which often keeps people away from health services

Pharmacotherapy (e.g., methadone) for recovering injection drug users
Traditional healing and treatment approaches

Promoting food security and micronutrient provision.

Comprehensive care options such as these are vital elements to address the HIV/AIDS crisis that is engulfing the world’s poor and yet, as we enter 2005 they are not being given adequate attention.

ACW Statement 2: Staying alive with HIV

HIV gradually subdues the immune system of people living with the virus so that opportunistic infections (OIs) such as candidiasis, meningitis and tuberculosis can then exploit the body’s weakened defences. People living in poorer parts of the world often have no access to clean water and sanitation, have bad nutrition and already weak health status, and are constantly challenged by a variety of infectious diseases. These factors place them at greater risk of HIV-associated OIs and are believed to significantly shorten the interval between initial HIV infection and the onset of AIDS-related conditions. As a result, HIV/AIDS is often called the ‘quintessential disease of poverty’.

But AIDS-related conditions can be prevented and treated with established forms of care, support and treatment, including readily available non-ARV medicines. AIDS deaths can be postponed without ARVs.

HIV/AIDS care is provided on a daily basis by medical services, families and communities throughout the world. In many of the countries hardest hit by the epidemic the demand for these care services has overwhelmed already fragile health and social systems. Nowhere in the world has this demand stabilized yet, and as more PWHAs fall ill, it can only increase. Without a health system to rely on, PWHAs in many countries have no option but to assume increasing responsibility for their own health.

To do so, people living with HIV need a variety of self-management abilities to monitor and control symptoms, and to minimize complications or delay their onset entirely. Health literacy is the ability to obtain, read, understand and act upon health information. It largely determines whether a person actively seeks health care when they need it and whether they and their families can make informed treatment decisions.

Meaningful advice and information is essential for people to change health-related behaviours, and assisting with self-management choices and adherence to available therapies. According to the International Alliance of Patients’ Organizations and other groups, however, there are many people who do not have sufficient health literacy to actively engage in their own health care in this way.

ACW Statement 1: Introduction

According to the latest UN estimates* over three million people will lose their life because of AIDS during the course of 2005. That is more annual AIDS deaths than ever before. Reaching for the ultimate goal of universal access to antiretroviral drugs is clearly vital - but as we strive for that goal we must keep those three million people alive in all possible ways.


Although AIDS-related deaths have fallen dramatically since the introduction of antiretroviral drugs (ARVs) in the late ‘90s, this has only happened in countries and communities where these medicines are available and affordable. Today, only one-in-eight of the six million people who need them have access to these life-saving drugs**.


Even when they are available, it is recommended that ARV drugs should only be taken once the progression of someone’s HIV infection - and the associated damage to their immune system - has reached a specific threshold. WHO estimates that approximately 15% - or 6 million of the 40 million people living with HIV/AIDS (PWHA) today - are beyond that stage and should be taking ARVs.


Access to ARVs is being expanded to the world’s poorer countries, but too slowly. Just over a year ago, for example, the World Health Organization (WHO) started a programme to ensure lifetime access to ARVs for three million people in developing countries by the end of 2005 (the so-called ‘3 by 5’ initiative).


However, many proponents of the 3 by 5 plan have already conceded that the goal will not be met on time. The director of WHO in Africa, Dr Ebrahim Malick Samba, has predicted that the 3 by 5 target will be reached “...but not as soon as expected”.


The Global Fund against AIDS, Tuberculosis (TB) and Malaria also offers immense hope that substantially more money will soon flow to countries for the provision of ARVs and other forms of HIV/AIDS care. But that too is seeing a slower than expected start - a pace largely determined by its donors.


Despite initiatives to expand ARV access and affordability, it appears unlikely that ARVs for all those who need them – or ‘universal access’ – will be achieved before at least 2008. In the intervening years, many of the people who need the drugs today will fall sick and die, and be replaced by further millions as they too progress to that threshold.


[* UNAIDS: AIDS Epidemic Update 2004 (23 November 2004) (http://www.unaids.org/); WHO: ‘3x5’ Progress Report 2005 (26 January 2005) (http://www.who.int/)]

Hidden health-care crisis denies effective, affordable HIV treatments to millions with HIV

ACW Campaign Announcement Comment here

A prevailing focus on the provision of antiretroviral (ARV) drugs is denying millions of people with HIV access to effective and affordable treatment options that could extend their lives.

In the first three months of 2005 alone, more people have already died from AIDS-related conditions than the total number taking ARVs throughout the world.

According to an unprecedented global campaign and civil society partnership being launched this week to coincide with World Stop-TB Day, this grim milestone is a stark reminder that as we grapple with the scale-up of global ARV access initiatives, we have to keep people with HIV alive in all possible ways.

The AIDS-Care-Watch (ACW) Campaign draws attention to the hidden healthcare crisis and leadership oversights that allow millions to die because other life-extending care options are being seriously neglected.

“The ACW campaign aims to raise awareness about all care and treatment options that are keeping people with HIV alive, particularly the vast majority who are waiting for antiretroviral treatment,” said Abigail Erikson, Campaign Coordinator. “The basic principle of the campaign is that humanity cannot let millions of people die from HIV-related conditions when life-saving care and treatment options exist.”

While AIDS-related deaths have fallen dramatically since the introduction of ARVs ten years ago, this has only happened where they are available and affordable, and that mostly means in wealthy nations. Today, only one-in-eight of the six million people who need them have access to life-saving ARVs. The vast majority of these people live in developing countries.

"Of course ARV drugs are critical to keeping us physically well - but without nutritious food, without additional therapies, and without the love and care of those who surround us, those drugs do little for us,” explained Alice Welbourn of the International Community of Women Living with HIV/AIDS (ICW), one of the organisations partnering the new campaign.

Tuberculosis (TB) is the biggest killer of people living with HIV/AIDS (PWHA), who have a 50% lifetime risk of developing the disease. Without prompt diagnosis and treatment for TB, death can come within weeks to someone with HIV. Effective TB treatment can extend lives of PWHA by at least two to three years and carries a 10US$ price tag.

Studies conducted in four African nations have also shown that preventive treatment of AIDS-related opportunistic infections with a cheap and safe, broad-spectrum antibiotic called ‘cotrimoxazole’, can reduce HIV-related death rates by up 50%. The evidence is so compelling that it prompted the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to recommend – five years ago - that the antibiotic should be given to Africans with symptomatic HIV infection. The annual cost of cotrimoxazole treatment is 6US$.

Despite being one of the areas of public health where we know the most, latest estimates to be released on World Stop-TB Day this week are expected to confirm that TB incidence in Africa is climbing sharply, especially in countries heavily impacted by the HIV epidemic, and that only about half of all TB cases in Africa are even detected. Similarly, the routine use of cotrimoxazole in developing countries, particularly sub-Saharan Africa, remains minimal despite explicit UN recommendations.


A doctor consults with TB patients at Ignace Dean Hospital, Guinea
Photo credit: WHO/TBP/Davenport

“People living with HIV/AIDS continue to die before their time because of a lack of appropriate treatment and a lack of understanding and information” said Greg Gray, Regional Coordinator of the Asia Pacific Network of People Living with HIV/AIDS (APN+). “We know only too well the importance of promoting prevention for opportunistic infections, yet still even this most basic and cost effective treatment is out of reach for many who desperately need it. APN+ is pleased to be a partner in this campaign and hope this can be a timely reminder to governments in making them accountable to the UNGASS declaration commitments and the ‘significant progress’ they have promised.”

The AIDS-Care-Watch Campaign stresses that advocating for the scale-up of such care services is not an excuse for governments, international agencies or communities to slow down or do less in their ARV expansion efforts – it must be additional to those efforts.

The campaign receives strong endorsements from entities such as the World Health Organization (WHO).

“We strongly support the goals of the ACW campaign because a holistic approach to care for all HIV-infected people is essential,” said Dr Paul Nunn, of the WHO Stop TB Department. “There is no point in getting people onto ARVs at great expense, only to have them die for lack of TB treatment with a fraction of those costs.”

During the course of this year, AIDS-Care-Watch is working with country-based partners to monitor whether previous commitments have been translated into care services at the local and national levels. The campaign uses a backbone of country-based reporting, documentation and analysis to hold relevant institutions and organisations accountable against their previous HIV/AIDS care commitments.

2005 is a benchmark year for a related prior commitment by over 180 governments. Four years ago, the UN General Assembly held an unprecedented special session on HIV/AIDS – the first time the assembly had ever addressed a specific health issue. The resulting Declaration of Commitment on HIV/AIDS, signed by all Member States of the UN, made explicit pledges to “make significant progress in implementing comprehensive [HIV/AIDS] care strategies” by 2005.

***

The AIDS-Care-Watch campaign is a global initiative with the goal of reducing the number of HIV-related deaths in 2005. The campaign has over 100 non-governmental and civil society partners. For more information about the campaign and its partners, please go to http://www.aidscarewatch.org/

Abigail Erikson, Global Campaign Board member
Email: info@aidscarewatch.org

2006 ACW Advisory Board

The AIDS-Care-Watch campaign is pleased to introduce members of the newly created ACW Advisory Board.

The Advisory Board is made up of over twenty-five people from all over the globe who are committed to ensuring that all people living with HIV and AIDS have access to the care they need. Our members have either been recruited or nominated themselves for involvement.

Each of the Board members have been selected because they are well aware of the care and treatment issues facing people living with HIV/AIDS, and are working hard to bring about change and save lives by advocating for essential, life-saving medicines to extend the lives of people living with HIV.

Board members will help guide the campaign and its activities over the course of 2006 and promote issues related to HIV/AIDS care and treatment.

The ACW campiagn thanks each and every one of our Advisory Board members for their time and commitment.

Best wishes,

ACW Campaign Secretariat

******************************************************
2006 ACW Advisory Board Members

Ms Elena Obieta, Physician, Argentina
Dr Rakesh Bharti, AIDS Awareness Project, India
Ms Celina D’Costa, Project Concern International, India
Mr Moses Orimolade Omisore, Literacy Advocacy Project, Nigeria
Ms Sara Page, SAFAIDS, Zimbabwe
Mr Johnstone Wanjala, Sima Community Based Organization, Kenya
Dr M. Ubaidullah, Ph.D, Professor, India
Ms Pauline Ngunjiri, Journalist, Carribean
Dr Nandlal Jotwani, Global Harmony Project, India
Ms Lydia Mungherera, Physician/ICW, Uganda
Dr Paul McQueen, Australia
Mr Lewis Ndlouvo, Synergy News South Africa
Dr. Timothy France, Health and Development Networks,Thailand
Mr Goodwin Gonde, Journalist, Malawi
Ms Felicity Hatendi, HIV/AIDS Specialist, Zimbabwe
Mr Edgar Lumbasio, Christian Partners Development Organisation, Zimbabwe
Dr Uzodinma A. Adirieje, Health Reform Foundation of Nigeria, Nigera
Ms Swapna Mujumdar, Journalist, India
Mr Ayi Georges AYAYI-MONI, Executive Director IFHES, Mali
Dr. Niloo Vaishnav, Bhavnagar Blood Bank, India
Ms Tonette B Lopez, GAHUM Phillipines Inc, Phillipines
G.H Anjun Khokhar, PEF Pakistan, Pakistan
Dr. Bharat Gopal, Engee Lung Institute and Research Cente, India
L.K. Verma, Seeking Waste Solutions Through Alternatives, India
Professor Shamsul Alam, Pratiddhani Somaj Unnayoan Sangstha, India
Bright Okebanum Aleruchi, Youth in Nigeria, Nigeria
Dr. SK Trivedi, Indian Institute of Development Management, India
Brijesh Dubey, RNP+, India
Mr Zakaullah Khan, Village Development Program, Pakistan

ACW UNGASS Action Alert

from ACW secretariat, August 2005

As most of you are aware, a key focus of the ACW campaign is to monitor national and international commitments to HIV/AIDS care and treatment.

Most recently the campaign highlighted the imminent disappointment of the World Health Organization’s ‘3 by5’ initiative and called for more attention to be paid towards scaling up access to other care options that keep people living with HIV/AIDS alive while they wait for antiretroviral drug programmes to deliver on their promises. (See ACW press release at http://www.aidscarewatch.org/cms/UserFiles/Image/ACW-PR-29Jun05.pdf)

It is clearly urgent to check progress on commitments made by national governments in relation to HIV/AIDS care and treatment. Four years ago, under the heading of ‘Global Crisis- Global Action’, the United Nations (UN) General Assembly held an unprecedented special session on HIV/AIDS (UNGASS) - the first time the assembly had ever addressed a specific health issue.

The resulting Declaration of Commitment on HIV/AIDS (DOC), signed by all member states of the UN, articulated a comprehensive framework to achieve Millennium Development Goal #6: “Halting and beginning to reverse the HIV/AIDS epidemic by 2015.”

In relation to HIV/AIDS care and treatment, our governments made explicit pledges to “…make significant progress in implementing comprehensive HIV/AIDS care strategies by 2005.”
The full care and treatment commitments governments promised to fulfill by 2003 and 2005 were:

55. By 2003, ensure that national strategies, supported by regional and international strategies, are developed in close collaboration with the international community, including Governments and relevant intergovernmental organizations, as well as with civil society and the business sector, to strengthen health-care systems and address factors affecting the provision of HIV-related drugs, including anti-retroviral drugs, inter alia, affordability and pricing, including differential pricing, and technical and health-care system capacity. Also, in an urgent manner make every effort to provide progressively and in a sustainable manner, the highest attainable standard of treatment for HIV/AIDS, including the prevention and treatment of opportunistic infections, and effective use of quality-controlled anti-retroviral therapy in a careful and monitored manner to improve adherence and effectiveness and reduce the risk of developing resistance; and to cooperate constructively in strengthening pharmaceutical policies and practices, including those applicable to generic drugs and intellectual property regimes, in order further to promote innovation and the development of domestic industries consistent with international law;

56. By 2005, develop and make significant progress in implementing comprehensive care strategies to: strengthen family and community-based care, including that provided by the informal sector, and health-care systems to provide and monitor treatment to people living with HIV/AIDS, including infected children, and to support individuals, households, families and communities affected by HIV/AIDS; and improve the capacity and working conditions of health-care personnel, and the effectiveness of supply systems, financing plans and referral mechanisms required to provide access to affordable medicines, including anti-retroviral drugs, diagnostics and related technologies, as well as quality medical, palliative and psychosocial care;

57. By 2003, ensure that national strategies are developed in order to provide psychosocial care for individuals, families and communities affected by HIV/AIDS.

It is now time to find out if they have delivered on those promises.

Beginning in August, all governments will be asked to compile reports of what progress they have made towards fulfilling the 2001 commitments. As required by the Declaration of Commitment, governments are to ensure a participatory and transparent approach throughout the reporting process. This means that civil society groups, including people living with HIV/AIDS networks, should be included in the national review and reporting process.

The progress review will take place from August until December 2005. The overall report will be presented in mid 2006, when a comprehensive assessment of national performance against specific targets laid out in the UNGASS Declaration of Commitment will be held in New York.

Get Involved!
Over the course of the next several months, there are several ways for ACW friends and partners to take action on this important process.

1. Complete the ACW Interview: AIDS-Care-Watch is conducting a large scale survey among its partners and key stakeholders to compile critical opinion about access to HIV/AIDS care and treatment. By completing the ACW Survey, you will help the campaign create a ‘real-life’ picture of access to essential HIV/AIDS care and treatment at the ground level, and in turn provide key information to show whether your government has fulfilled its promises on care and treatment. To complete the interview, please go to: http://www.aidscarewatch.org/cms/subcategory.asp?sid=94

If you have already completed the survey, please see the next two actions!

2. Tell others: Forward this message onto to your friends and colleague working in HIV/AIDS and encourage them to complete the ACW Interview.

3. Tell us: Please let ACW know if you would like to be introduced to the organization that is coordinating civil society input in your country’s UNGASS report for 2005.

More information and updates will be shared with ACW friends and partner as they become available. If you have further information or experience with the UNGASS 2005 reporting process that you would like to share with others, please let us know.

Best wishes,
Abigail Erikson
Abigail@aidscarewatch.org

Staying Alive with HIV during the long wait for ARVs

While international attention remains focused on "scaling up" the response to HIV/AIDS, in particular on increasing access to antiretroviral (ARV) treatment, the epidemic is outpacing both prevention and treatment efforts. In the first three months of 2005, more people died of AIDS-related conditions than the total number of people who are on ARVs.

In the Asian region, the number of people receiving ARVs has increased three-fold in the past year, from 55,000 to 155,000. Despite such progress, this is a small fraction of the number of people who need ARVs in order to survive. The numbers speak for themselves: The overall proportion of people in the region with advanced HIV infection receiving ARVs remains low, mirroring the global average of around 15%. This means that one million Asians with HIV who currently need ARV treatment do not get them.

Globally, it is estimated that 6 million people currently need ARV treatment, compared to only one million currently taking the life-saving medicines.

More than 250 non-government organisations in the Asia-Pacific region have joined forces in the AIDS-Care-Watch campaign in an effort to draw attention to this "treatment gap" and to the people who are dying as they wait for ARV treatment. The campaign calls for a broader treatment and care strategy: In addition to ARV treatment expansion, there must also be greatly increased efforts to keep people alive until they receive ARVs.

A satellite session organised by the AIDS-Care-Watch campaign and its partner organisations during the ICAAP congress addressed these issues. The session brought to light an emerging regional crisis in care that means comprehensive approaches to care and support for people living with HIV/AIDS are being ignored.

"The AIDS-Care-Watch campaign aims to raise awareness about all care and treatment options that are keeping people with HIV alive, particularly the vast majority who are waiting for antiretroviral treatment," said Abigail Erikson, ACW Campaign Coordinator. "The basic principle of the campaign is that humanity cannot let millions of people die from HIV-related conditions when life-saving care and treatment options exist."

Erikson stressed that non-ARV treatments were not intended as a substitute or replacement for ARV therapy, and insisted that governments should speed up, not slow down, their ARV roll-out plans.

"Advocating for the provision of other HIV/AIDS prophylaxis and treatment options to keep people alive," she insisted, "is not an excuse for governments, international agencies, or communities to slow down or do less towards expanding ARV programmes."

Other treatment advocates are lining up behind the campaign. More than 250 organisations are also speaking out about the lack of access to basic health services, as well as ARV treatment.

Rajiv Kafle, a treatment activist from Nepal, who is himself living with HIV, says the lack of these basic services is a critical issue. He says people in his treatment and care project are dying unnecessarily because they do not have simple prophylaxis drugs for some of the most common opportunistic infections, such as tuberculosis (TB) or pneumonia. Treatment for TB is cheap and effective, and can often extend the lives of HIV positive people by years – for about $10. Another drug, the antibacterial agent cotrimoxazole, is effective against a number of opportunistic infections and only costs about $6 for a year’s treatment.

"Those deaths could have been prevented or treated, and they could have lived for many more years," Kafle said. "If we had prioritised this agenda a few years ago, we could have prevented those deaths."

Bijan Nassiri, a doctor who runs a harm reduction program in Iran, said that the likely failure of the WHO-led "3by5" treatment plan to meet its target has brought into focus the need for NGO and community participation in treatment initiatives. "This is the time for some big organisations…to come forward and say "we have failed" and ask for help from civil society…It seems something like honesty, not a very technical point."

And if that sort of acknowledgment is not forthcoming, campaign members say they will step forward to put pressure on governments, funders, and other institutions to live up to their commitments to protect the basic health of people with HIV/AIDS.

"That’s part of what AIDS-Care-Watch is trying to do," said campaign coordinator Erikson, "to create avenues where treatment advocacy groups can come together and discuss comprehensive care…We are trying to form a critical mass of organisations that are asking these questions…we need voices, we need to have a groundswell from the bottom."

HDN Key Correspondent Team
Email: correspondents@hdnet.org
Web: www.hdnet.org

Staying alive with HIV

The AIDS-Care-Watch Campaign has a simple, yet crucial message: while the ultimate goal of universal access to antiretroviral drugs is imperative, we must protect people’s right to health and keep them alive in all possible ways. Today—World TB Day—the campaign completes its first year.

An unprecedented global civil society campaign – AIDS-Care-Watch (ACW) – launched on World TB Day 2005 [March 24] advocates an essential and hopeful message: AIDS deaths can be postponed while we wait for ARVs.

While the campaign recognises that universal access to antiretroviral (ARV) drugs is vital and must be pushed for at every level, ACW also knows that providing access to ARVs for all those who need them – or ‘universal access’ – is unlikely to be achieved before at least 2010.

In the intervening years, many people living with HIV (who need the drugs today) will fall sick and die, and will be joined by further millions. It is preventing these unnecessary deaths that have propelled over 350 organisations worldwide to band together and advocate for a wide range of care and treatment options to be made available to people living with HIV.

"Of course ARV drugs are critical to keeping us physically well – but without nutritious food, without additional therapies, and without the love and care of those who surround us, those drugs do little for us,” explains Alice Welbourn of the International Community of Women Living with HIV/AIDS (ICW), an ACW partner.

AIDS-Care-Watch contends that AIDS-related conditions can be prevented and treated with established forms of care, support and treatment, including readily available non-ARV care and treatment options.

Many organisations have joined the campaign because they are tired of watching their friends, family and colleagues die because ARVs, and other affordable and effective care and treatment options are often not available when they are needed.

“People living with HIV/AIDS continue to die before their time because of a lack of appropriate treatment and a lack of understanding and information” said Greg Gray, former Regional Coordinator of the Asia Pacific Network of People Living with HIV/AIDS (APN+), also a partner to the campaign.

“We know only too well the importance of promoting prevention for opportunistic infections, yet still even this most basic and cost effective treatment is out of reach for many who desperately need it.”

In response to this reality, AIDS-Care-Watch provides an avenue for treatment activists and advocates worldwide to come together to advocate for a comprehensive care package for people living with HIV.

Comprehensive care for people living with HIV is not a new idea, but a unified, popular and vocal advocacy campaign to promote it is. And given the overwhelming response to the relatively young campaign, it is clearly warranted.

Each of us living with and/or working on HIV recognises that a full range of care and treatment elements is required to improve and extend our lives. Access to treatment and prevention for tuberculosis and other opportunistic infections, voluntary counselling and testing, assured food security, home and community based care, among others, are all part of the essential AIDS care package.

AIDS-Care-Watch advocates for a comprehensive package of AIDS care and treatment services under one standard. By keeping the advocacy agenda of AIDS-Care-Watch broad, it is proving relevant to most communities and appeals to activists, advocates, AIDS service organizations and people with HIV globally.

This is crucial to generating a single collective voice to influence decisions related to care and treatment at all levels. With the UNGASS review meeting, to measure the progress made against specific targets laid out in the Declaration of Commitment taking place this June [2006], an opportunity to have an impact on the future direction of AIDS care and treatment priorities is at hand.

The ACW campaign is strongly advocating that greater emphasis be placed on making a wide range of care and treatment options available for people living with HIV– particularly for those still in need of ARVs.

The basic principle of the campaign is that humanity cannot let millions of people die from AIDS-related conditions when life-saving care and treatment options exist. For the millions of people living with HIV who are not able to afford or access ARVs today, there are nevertheless many ways that their lives can be extended. The ACW campaign theme ‘Staying Alive with HIV’ is about spreading this hope.

Bobby Ramakant, ACW’s South Asia Campaign manager, is convinced that the campaign’s message of comprehensive care should become a priority for global TB and HIV programmes.

“The issues raised by the campaign got the support of so many partners – on the 365th day, we are looking to welcome our 365th partner – is evidence of how urgent and important these issues are.”

Source: Abigail Erikson, AIDS Care Watch Board Member